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Pecquet C, Papadopoulos N, Balligand T, Chachoua I, Tisserand A, Vertenoeil G, Nédélec A, Vertommen D, Roy A, Marty C, Nivarthi H, Defour JP, El-Khoury M, Hug E, Majoros A, Xu E, Zagrijtschuk O, Fertig TE, Marta DS, Gisslinger H, Gisslinger B, Schalling M, Casetti I, Rumi E, Pietra D, Cavalloni C, Arcaini L, Cazzola M, Komatsu N, Kihara Y, Sunami Y, Edahiro Y, Araki M, Lesyk R, Buxhofer-Ausch V, Heibl S, Pasquier F, Havelange V, Plo I, Vainchenker W, Kralovics R, Constantinescu SN. Secreted mutant calreticulins as rogue cytokines in myeloproliferative neoplasms. Blood 2023; 141:917-929. [PMID: 36356299 PMCID: PMC10651872 DOI: 10.1182/blood.2022016846] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/05/2022] [Accepted: 10/17/2022] [Indexed: 11/12/2022] Open
Abstract
Mutant calreticulin (CALR) proteins resulting from a -1/+2 frameshifting mutation of the CALR exon 9 carry a novel C-terminal amino acid sequence and drive the development of myeloproliferative neoplasms (MPNs). Mutant CALRs were shown to interact with and activate the thrombopoietin receptor (TpoR/MPL) in the same cell. We report that mutant CALR proteins are secreted and can be found in patient plasma at levels up to 160 ng/mL, with a mean of 25.64 ng/mL. Plasma mutant CALR is found in complex with soluble transferrin receptor 1 (sTFR1) that acts as a carrier protein and increases mutant CALR half-life. Recombinant mutant CALR proteins bound and activated the TpoR in cell lines and primary megakaryocytic progenitors from patients with mutated CALR in which they drive thrombopoietin-independent colony formation. Importantly, the CALR-sTFR1 complex remains functional for TpoR activation. By bioluminescence resonance energy transfer assay, we show that mutant CALR proteins produced in 1 cell can specifically interact in trans with the TpoR on a target cell. In comparison with cells that only carry TpoR, cells that carry both TpoR and mutant CALR are hypersensitive to exogenous mutant CALR proteins and respond to levels of mutant CALR proteins similar to those in patient plasma. This is consistent with CALR-mutated cells that expose TpoR carrying immature N-linked sugars at the cell surface. Thus, secreted mutant CALR proteins will act more specifically on the MPN clone. In conclusion, a chaperone, CALR, can turn into a rogue cytokine through somatic mutation of its encoding gene.
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Affiliation(s)
- Christian Pecquet
- Ludwig Cancer Research, Brussels, Belgium
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
| | - Nicolas Papadopoulos
- Ludwig Cancer Research, Brussels, Belgium
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
| | - Thomas Balligand
- Ludwig Cancer Research, Brussels, Belgium
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
| | - Ilyas Chachoua
- Ludwig Cancer Research, Brussels, Belgium
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
| | - Amandine Tisserand
- INSERM, Unité Mixte de Recherche (UMR) 1287, Gustave Roussy, Villejuif, France
- Université Paris Cité, UMR 1287, Gustave Roussy, Villejuif, France
- UMR 1287, Gustave Roussy, Villejuif, France
| | - Gaëlle Vertenoeil
- Ludwig Cancer Research, Brussels, Belgium
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
| | - Audrey Nédélec
- Ludwig Cancer Research, Brussels, Belgium
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
| | - Didier Vertommen
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
| | - Anita Roy
- Ludwig Cancer Research, Brussels, Belgium
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
| | - Caroline Marty
- INSERM, Unité Mixte de Recherche (UMR) 1287, Gustave Roussy, Villejuif, France
- UMR 1287, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, UMR 1287, Gustave Roussy, Villejuif, France
| | - Harini Nivarthi
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Jean-Philippe Defour
- Ludwig Cancer Research, Brussels, Belgium
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
| | - Mira El-Khoury
- INSERM, Unité Mixte de Recherche (UMR) 1287, Gustave Roussy, Villejuif, France
- UMR 1287, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, UMR 1287, Gustave Roussy, Villejuif, France
| | - Eva Hug
- MyeloPro Diagnostics and Research GmbH, Vienna, Austria
| | | | - Erica Xu
- MyeloPro Diagnostics and Research GmbH, Vienna, Austria
| | | | | | - Daciana S. Marta
- Ultrastructural Pathology Lab and Bioimaging, Institute of Pathology Victor Babeș, Bucharest, Romania
| | - Heinz Gisslinger
- Division of Hematology and Blood Coagulation, Department of Internal Medicine I, Division of Hematology and Blood Coagulation, Medical University of Vienna, Vienna, Austria
| | - Bettina Gisslinger
- Division of Hematology and Blood Coagulation, Department of Internal Medicine I, Division of Hematology and Blood Coagulation, Medical University of Vienna, Vienna, Austria
| | - Martin Schalling
- Division of Hematology and Blood Coagulation, Department of Internal Medicine I, Division of Hematology and Blood Coagulation, Medical University of Vienna, Vienna, Austria
| | - Ilaria Casetti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Elisa Rumi
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Daniela Pietra
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Chiara Cavalloni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Mario Cazzola
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Norio Komatsu
- Department of Hematology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshihiko Kihara
- Department of Hematology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshitaka Sunami
- Department of Hematology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoko Edahiro
- Department of Hematology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Marito Araki
- Department of Transfusion Medicine and Stem Cell Regulation, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Roman Lesyk
- Department of Biotechnology and Cell Biology, Medical College, University of Information Technology and Management in Rzeszow, Rzeszow, Poland
- Department of Pharmaceutical, Organic and Bioorganic Chemistry, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Veronika Buxhofer-Ausch
- Department of Internal Medicine I with Hematology, Ordensklinikum Linz Elisabethinen, Stem Cell Transplantation Hemostaseology and Medical Oncology, Linz, Austria
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Sonja Heibl
- Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Florence Pasquier
- INSERM, Unité Mixte de Recherche (UMR) 1287, Gustave Roussy, Villejuif, France
- Université Paris Cité, UMR 1287, Gustave Roussy, Villejuif, France
- UMR 1287, Gustave Roussy, Villejuif, France
- Department of Hematology, Gustave Roussy, Villejuif, France
| | - Violaine Havelange
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
- Department of Hematology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Isabelle Plo
- INSERM, Unité Mixte de Recherche (UMR) 1287, Gustave Roussy, Villejuif, France
- UMR 1287, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, UMR 1287, Gustave Roussy, Villejuif, France
| | - William Vainchenker
- INSERM, Unité Mixte de Recherche (UMR) 1287, Gustave Roussy, Villejuif, France
- UMR 1287, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, UMR 1287, Gustave Roussy, Villejuif, France
| | - Robert Kralovics
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Stefan N. Constantinescu
- Ludwig Cancer Research, Brussels, Belgium
- Université Catholique de Louvain and de Duve Institute, SIGN Unit, Brussels, Belgium
- Walloon Excellence in Life Sciences and Biotechnology, Brussels, Belgium
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
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Tvorogov D, Thompson-Peach CAL, Foßelteder J, Dottore M, Stomski F, Onnesha SA, Lim K, Moretti PAB, Pitson SM, Ross DM, Reinisch A, Thomas D, Lopez AF. Targeting human CALR-mutated MPN progenitors with a neoepitope-directed monoclonal antibody. EMBO Rep 2022; 23:e52904. [PMID: 35156745 PMCID: PMC8982588 DOI: 10.15252/embr.202152904] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 01/02/2023] Open
Abstract
Calreticulin (CALR) is recurrently mutated in myelofibrosis via a frameshift that removes an endoplasmic reticulum retention signal, creating a neoepitope potentially targetable by immunotherapeutic approaches. We developed a specific rat monoclonal IgG2α antibody, 4D7, directed against the common sequence encoded by both insertion and deletion mutations. 4D7 selectively bound to cells co‐expressing mutant CALR and thrombopoietin receptor (TpoR) and blocked JAK‐STAT signalling, TPO‐independent proliferation and megakaryocyte differentiation of mutant CALR myelofibrosis progenitors by disrupting the binding of CALR dimers to TpoR. Importantly, 4D7 inhibited proliferation of patient samples with both insertion and deletion CALR mutations but not JAK2 V617F and prolonged survival in xenografted bone marrow models of mutant CALR‐dependent myeloproliferation. Together, our data demonstrate a novel therapeutic approach to target a problematic disease driven by a recurrent somatic mutation that would normally be considered undruggable.
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Affiliation(s)
- Denis Tvorogov
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA, Australia
| | - Chloe A L Thompson-Peach
- Cancer Program, Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide, Adelaide, SA, Australia.,Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Johannes Foßelteder
- Department of Internal Medicine, Division of Haematology, Medical University of Graz, Graz, Austria
| | - Mara Dottore
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA, Australia
| | - Frank Stomski
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA, Australia
| | - Suraiya A Onnesha
- Cancer Program, Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide, Adelaide, SA, Australia.,Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Kelly Lim
- Cancer Program, Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide, Adelaide, SA, Australia.,Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Paul A B Moretti
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA, Australia
| | - Stuart M Pitson
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA, Australia.,Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - David M Ross
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA, Australia.,Cancer Program, Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide, Adelaide, SA, Australia.,Department of Haematology, Flinders University and Medical Centre, Adelaide, SA, Australia
| | - Andreas Reinisch
- Department of Internal Medicine, Division of Haematology, Medical University of Graz, Graz, Austria.,Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Daniel Thomas
- Cancer Program, Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide, Adelaide, SA, Australia.,Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Angel F Lopez
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA, Australia.,Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
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